Mental Health Education - rational emotive behaviour education

Children are constructing their own views on things (philosophies) making meaning from what they see and hear in their interactions with others and the world. The conclusions they draw may be helpful or unhelpful (rational or irrational) – their ‘thinking rules.’ (unconscious/unaware)

Behaviour management is not individualised – what philosophies do those children hold (constructed)? Do they know them? How do they effect emotional and behavioural responses to situations? What can they learn/relearn that will help them?

One size fits all – assumes that:

• Children know how to behave
• They have all been exposed the same learning/experiences
• They therefore should know how to behave
• If they don’t behave appropriately they should be punished (because they should Know better) – This will not be the articulated position of the teacher/parent/other (they too may be unaware of their own constructed philosophies!)

This is a short term fix at best but it will:

• Not make sense to the child (doesn’t factor in what ‘thinking rules’ they have constructed)
• Children are blamed/judged on their behaviour
• Children believe they are ‘bad’
• Social and emotional problems – anxiety, depression, anger, shame
• Can’t engage in learning – ‘I’m bad/stupid/worthless/dumb.’

REBE is a long term approach to mental health/well being. It:

• Alerts students to their ‘thinking nature.’
• Helps them identify what they believe and why and how this relates to how feel and behave
• Empowers them to monitor emotions, check thinking, recalibrate – is this as big a problem as I believe it is?
• Helps them to challenge and change destructive personal philosophies that are not based in fact and which cause them (selves) grief
• Reduces the incidence of major mental health conditions like depression and anxiety

The REBE in Schools Program

• Recognises the dignity of the person (no shame job)
• Is teacher/student/parent friendly
• Is based on well tested psychological principles (REBT)
• Recognises students as constructivists – ‘Depression is by and large constructed therefore it can be deconstructed.’ Albert Ellis
• Is systematic, relentless, comprehensive and effective in its mission
• Is highly cost effective
• Is home grown

An Anxious Adolescent - part 3

The student continues to explore the idea that events don’t cause our extreme ill feelings but rather it is our interpretation or thinking about them that does. The belief we are worthwhile only when others do is an errant philosophical view and our student is beginning to realise that his unrealistic demand that others MUST like him to be likeable is doing him a disservice.

In the counselling office in a school in South Australia

Counsellor:   You say that you feel anxious when you think you have ‘offended’ someone. Is that fair to say?

Student:  Yes I want people to be happy. I hate it when they feel bad because of me.

Counsellor:  It would appear that you believe you are responsible for how others feel. You say you ‘made him upset.’ Would that also mean that you believe others ‘make you upset?’

Student:  Yes. People can make me upset and I can upset others.

Counsellor:   I want to talk about a ‘must’ rule that people make over time. It is a rule that is not a helpful one to have.

Student:  What do you mean? Do I have a must rule? I don’t think I do.

Counsellor:   What do you think about the rule ‘people must like me or I’m no good?’

Student:  I’m not sure what you mean. Where does this rule come from?

Counsellor:  OK instead of using the word ’rule’ replace it with ‘belief.’  Say ‘I believe I’m OK only when people think I am.’ (Student repeats statement). A belief is a strongly held view about something that we believe is true.

Student:  Why do I believe this? Where does it come from?

Counsellor:   You have learnt this from an early age. You have learnt that you are only ‘good’ if others think you are ‘good.’ When someone disapproves of aspects of your personality or something you do you don’t just feel disappointed you feel really anxious and sad. Someone or something is not ‘making’ you anxious but your ‘thinking rule’ your ‘must belief’ is!

‘It's lack of faith that makes people afraid of meeting challenges, and I believed in myself.’ Muhammad Ali 

Student:  Do you mean that my belief that that kid I was talking about ‘must like me and think I am a good person’ is what is causing my anxiety?

Counsellor: Yes exactly! Your belief (that you believe is true) is making you anxious because you don’t get what you must have and that it is really awful that you don’t. You think you need the acceptance of others to be worthwhile!

Student:  Isn’t it normal to want other people to like me? I try very hard to be liked.

Counsellor:  We may want to be liked and admired by others but really needing others’ attention and admiration to ‘make’ us feel worthwhile and accepted is an unhealthy MUST rule. That is ‘people must like us for us to feel good about ourselves.

Student:  OK I am getting the hang of this. Other people who might disapprove of my behaviour don’t cause my anxiety but my must belief does. I think ‘he must think I am a good person.’ Is that right?

Counsellor: Yes, well done. Not only must he approve of you but it is so awful that you can’t stand it when he doesn’t!  You must get what you want and when you don’t you feel highly anxious and very unhappy.  You will maintain your anxiety as long as you believe your MUST belief/rule.

Student:  How do I change my unhelpful rule? How can I learn to manage my extreme worry?

Counsellor: The antidote to ‘I must have the approval of others for me to feel OK’ is Unconditional Self-Acceptance (USA). It means ‘I accept myself, warts and all even when I stuff up, even when someone disapproves of me in some way!’ This is a healthy rule/belief because you remain in control. You remain healthily concerned but not so anxious that you can’t focus on your work.

Student:  So when someone thinks I have done something bad I’m not bad, is that what you are saying? 

Counsellor:  Yes you are always worthwhile no matter what, even when you screw up or someone rejects you. When you asked someone if they had a problem and he mistook what you said and showed annoyance towards you it did not in any way take away your value. You are only worthless if you believe you are and you believe you are when you believe ‘I MUST have the approval of others to be worthwhile.’

Student:  I get what you mean.

Counsellor:  Practise believing ‘I prefer others to approve of me but they don’t have to. I accept myself no matter what. I can handle this.’

Student:  I’ll do that. Thanks. 

''I don't have to be what you want me to be.'' Muhammad Ali

An Anxious Adolescent - part 2

This 14 year old student has had a reasonable week. He has been aware of how his anxiety has ebbed and flowed in his interactions with others and is monitoring his self-talk. He is very careful about what he says and how he says it and is quick to help and encourage others with enthusiasm. Other students have commented that he is ‘overly helpful and encouraging’ at times and would prefer he ‘relax a bit.’

Counsellor: G’day. How’s it going?

Student: I’m fine. I’ve been thinking about our last chat and I think it’s true that I worry too much about what others think.

Counsellor: You’re not alone, and it’s useful that you have been thinking about your anxiety and what might be causing it. Last time we spoke we talked about ‘needing the approval of others.’ Do you recall?

Student: Yeah. I’ve been thinking a lot about this. I do want to be liked by others. Isn’t it OK to want be liked by everyone?

Counsellor: Can you be liked by everyone? Do you think this is a reasonable expectation to have of others?

Student: I try hard not to offend anyone so shouldn’t they think well of me?

Counsellor: Want and need are interesting ideas. Can you see a difference between the two?

Student: Yes I think need is stronger than want, like you need water to survive but you don’t need to have chocolate. Without water you will die but without chocolate you can still survive!

Counsellor: Well explained. What is the difference between wanting to have others like and respect you and needing others to like and respect you?

Student: I get what you mean. I’m into needing others to like me, like I will die if they don’t! That’s what’s going on with me, that’s why I feel so bad when other people seem not to like me. That’s why I try hard to please them!

Counsellor: I think you are working it out pretty well. You have identified a belief or rule that you have that is not helpful to you because your anxiety is linked to this rule. Do you know what your rule might be?

Student: I have an idea that it’s something to do with my need for others to approve of me. Am I warm?

Counsellor: You are very warm, hot even. Can you begin saying your rule with: ‘I need the..

Student: OK. I need the approval of others.

Counsellor: Yes but why?

Student: I need them to like me so I can feel good about myself.

Counsellor: Yes indeed. Well done! And when you don’t get the recognition or approval you ‘need’ how do you feel? And how does this effect your life?

Student: I feel really anxious and I can’t concentrate on anything because I have made someone upset.

Counsellor: Well done! You’re beginning to understand where your anxiety comes from. You have worked out what your feelings and behaviours are connected to. What would that be?

Student: That would be my rule wouldn’t it?

Counsellor: Yes or belief. Tell me what your rule is but instead of beginning with ‘my rule is’ use ‘I believe that’ instead.

Student: OK. I believe that I need the approval of others for me to feel OK. How’s that?

Counsellor: So who or what is ‘making’ your anxiety?

Student: I think my rule or belief makes my anxiety. Would that be right?

Counsellor: Yes I agree that you have developed a MUST belief. People you like and respect MUST like and respect you but ‘must’ they? Can they?

Student: I’m beginning to understand that I can’t expect everyone I like to like me but it’s hard for me to accept this. But it makes sense.

Counsellor: It might make sense but you have been practicing this MUST rule all your life and it will be difficult to replace it with a healthier more sensible rule.

Student: What would that be?

Counsellor: You might want chocolate but you don’t have to have it. You might want their approval but you don’t have to have it to be OK. How could you express the notion that you might want chocolate but you don’t absolutely need it? Clue - use ‘prefer’ in your sentence!

Student: OK. I would prefer to have some chocolate but I don’t have to have it. I prefer people I like to like me but they don’t have to.

Counsellor: Will you die of you don’t get any chocolate? Will you die if someone you like doesn’t like you? Would it be so awful that you couldn’t stand it?

Student: No I wouldn’t die and I could stand it but I wouldn’t like it, I still wouldn’t like it!

Counsellor: No it would be bad but not so bad that you couldn’t stand it. You can’t always get what you want and that’s true don’t you think? You might not get what you want (them to like you) but you are still OK even if they don’t. We will talk about this further in the next session. Well done.

I had intended to talk about Unconditional Self-Acceptance (USA) but I have taken a while to get to this point. The student has shown considerable insight into what he believes (his philosophy) and how this drives his anxiety. Intellectually he understands what’s going on, he can talk the talk. But it will be a while and take a lot of hard work before he will automatically walk it. This is called emotional insight and we will continue with this case study in the next post. This is Rational Emotive Behaviour Education at work. Good one Dr. Ellis!

An Anxious Adolescent - part 1

This is a transcript of a series of 3 counselling sessions I had with a year 10 student. I used Albert Ellis' ABC Theory of Emotional Disturbance to help him. I am a Rational Emotive Behaviour Counsellor.

This student feels anxious over something that has happened. He asked another student if he had a problem (are you OK? Can I help?). This was misinterpreted (what do you mean I have a problem?) and he responded aggressively. The student was taken aback and then began to mull over the response he received. He asked a trusted teacher if the esteem in which other teachers held him was now diminished. The teacher said not in any way but the student remained preoccupied and went to see the counsellor outlining what had happened and how best to deal with the situation.

In the counsellors office

Student: I am concerned about how a student responded to me. I am caring and I didn’t intend to offend him when I asked him how he felt and if I could help. I am worried that he thinks I intended to offend him. I want to be a nurse one day; everyone knows I like to help.

Counsellor: So you asked him if he had a problem and he didn’t appreciate the questions. He felt annoyed. Is that right?

Student: Yes and I don’t understand why he felt that way. Anyone who knows me would say that I am caring and I am genuine when I ask how someone is.

Counsellor: You are caring and considerate of others generally and you are known for this. One individual has interpreted your intentions in a negative way and you feel upset and worried about this.

Student: Yes I do. I asked Mr S. if the other teachers would think less of me because I have offended someone. I am worried about this.

Counsellor: Using the Emotional Thermometer how would you rate the intensity of how you feel? How strong is your worry?

Student: It is around 9/10.

Counsellor: That’s strong. How often do you feel like this and for how long?

Student: Most of the time I feel anxious about things.

Counsellor: How does this affect your day-to-day life? Does it help you achieve your goals or get in the way?

Student: I can’t focus on what I have to do.

Counsellor: That would be stronger than concern or worry. Do you know what

anxiety is?

Student: Yes I do.

Counsellor: From what you tell me you feel anxious a lot of the time because you want everyone to like you and you think it would be terrible if anyone thought badly of you. You really care about what others think of you.  Do you think you care too much? Do you need other people to approve of you for you to feel OK?

Student: How did you know that?

Counsellor: The belief that ‘I am OK only if others think I am’ is an unhealthy belief because it stops you from working towards your goals. You feel nervous and worried a lot of the time (unhealthy negative feelings) because you think it would be terrible if anyone knew you made mistakes or didn’t seem to approve of you.

Student: This stops me from being successful because I can’t concentrate on my work because I feel very worried a lot of the time! I worry too much about what others think of me but I can’t seem to stop doing this.

Counsellor: You have the tendency to believe that everyone must like you because you are a likeable and caring person and others should recognise this. Is this fair to say?

Student: Yeah. I just can’t handle it. What can I do?

Counsellor: We will look at your belief that you need everyone’s approval to be OK and why this is keeping you anxious. We will work on this next time we meet. In the meantime remind yourself that you don’t need other people’s approval to be OK. You can prefer it but you don’t need it.

'Just be positive' (and other useless advice) - an REBT perspective

The 70's and 80's heralded the introduction of the 'warm fuzzies' movement. I recall a colleague saying thanks for the 'warm fuzzies' when congratulated on something he'd done. He and others would talk about giving and receiving warm fuzzies and how if you 'just be positive' things will work out in your favour. I'm all for people feeling OK and encouraging others but I would recoil at the mere mention of them (warm fuzzies).

And the word 'just' invoked a level of discomfort; as if you could flick a switch and all would be well! Just think positive. Just believe in yourself. Just have faith in yourself. You are special etc. This as useful as responding to someones concerns relative to how 'this happened to me. I know exactly how you feel. Just think positive!'

Sometimes all you can do is listen and that's good enough. We can feel compelled to fill the wordless void by offering platitudes and assurances that may not be useful to the person who is in need of a 'friendly ear.'

Now I do believe that thinking positively is a useful thing to do. There's a difference however between thinking you're OK and believing you're OK. What's the difference? The former can be fanciful and warm fuzzyish (I told myself I'm OK when you ignore me but I still feel like shit!) the latter is more substantial (I know I'm OK even if you don't think so - disappointed not depressed!)

The need to be needed?

Self belief takes work. It's a journey from intellectual insight (I understand what this means) to emotional insight (I now act and feel according to my practised and established unconditional self acceptance belief).

This work will take the student or client to places of risk where failure and possible criticism and admonishment from others may ensue. You know you are on your way when your sense of self belief remains in tact even when you are under siege; you are healthily disappointed or upset but not depressed. You resolve to try again because now you know (believe) you are OK no matter what.

This is taught to students in schools through the Rational Emotive Behaviour Education in Schools program. Based on Albert Ellis' ABC Theory of Emotional Disturbance students are taught that their worth is never contingent on how others view them or how well or badly they perform at a task.

It takes work and practise to develop new habits of thinking i.e. You

• Gain insight into what you believe to be true or false
• Challenge the errant irrational belief you may hold - what evidence supports this belief?
• Deconstruct old thinking habits and build new ones - practise, try things that you may not have tried and experience success and failure
• Develop the psychological muscle that will keep you strong especially when challenged

When a person is truly self accepting she is more inclined to open herself up to new opportunities and experiences because she no longer surrenders her worth to the opinion of others or the mistakes she will inevitably make.

Forget warm fuzzies and invest in some self acceptance learning.

Mental Health Promotion - South Australian schools on the ball!

According to 'A Way Forward: Equipping Australia’s Mental Health System for the Next Generation :

'Online mental health services can involve cognitive behaviour courses that help people identify unhelpful thoughts and behaviours and learn healthier skills and habits.'

Online MH support services the report says are low cost and highly effective. Young people who are struggling with mental health concerns are finding online support useful to them. Cognitive Behaviour Therapy (CBT) courses are available to help young people identify, challenge and change unhelpful thoughts.

This is precisely what teachers are doing at Para Hills School P-7 in Adelaide South Australia.

Through the Rational Emotive Behaviour Education Program children are taught how to develop healthy habits of thinking about themselves, others and the world. Teachers do this across all curriculum areas at every year level day in and day out. This very important school based approach to MH promotion/development/prevention/intervention complements and supports community based mental health promotion like ReachOut, HeadSpace and the like.

Albert Ellis who is considered the grandfather of CBT was aware of what schools were doing in South Autsralia and supported work here up until his death in 2007.

Well done all teachers who embed MH teaching and learning in daily practice.

Para Hills School P-7 teachers a step ahead and cooking with gas! smile emoticon

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Getting on with 'it'

When 'it' is causing you to feel sad, inert, sluggish, aimless and generally down sometimes the best thing to do is just keep going. There could be a plethora of 'its' that ails us - past traumas, anxieties about the future, fears of today. Which 'it' is it? Or are they many and varied? We can become bogged down in rumination and contemplation which can ultimately overwhelm us until we stop altogether and resign from the world i.e. the big 'it' that is 'making' us so sad - 'stop the world. I want to get off!' As has been observed over the millenia it isn't 'it' that makes us feel as we feel and do what we do.Oh no! Its our estimation of 'it' that does us in! The world is as it is and is neither good or bad but our thinking about 'it' determines whether 'it' is indeed good or bad. As the great Albert Ellis once said:

The world ain't for you or against you. It just doesn't give a shit!

In a blog post writer and comedian Catherine Deveny talks about everyday heroes. These are the people who get on with 'it' (the pressures and strains, trauma and challenge of daily living). Unheralded and anonymous they plough on, survive and hopefully thrive despite their personal trials and tribulations. Some will sadly give in to the pain that ultimately overwhelms them. 

Catherine offers the following advice from her own experiences through her writing in this blog post written in 2008.

http://www.catherinedeveny.com/just-keep-going-a-tribute-to-everyday-heroes/

Catherine says:

1. Every day the sun will rise. It is a different day with endless possibilities.

2. "This too will pass." These words, engraved on an ancient Sultan’s ring, made him solemn in happy times and happy during sad times. Remember these always.

3.You are amazing. You’re doing a great job. Just. Keep. Going.

Albert Ellis, REBT and Rubbish Bins

I was doing my rounds at school the other day. A young student (7 years old) had a waste paper bin over his  head. This sounds a bit like the intro of a joke (I went to the doctor the other day...). Anyway I spoke to the student and he told me he did this because 'I'm rubbish and that's where I belong.' On other occasions he had said to me that he was bad/naughty.

This kind of talk would suggest to me (as a Rational Emotive Behaviour Educator) that the child has constructed a view of himself that is irrational and therefore self defeating. Somehow he has concluded that he has no worth ('I'm rubbish') which is reflected in his poor behaviour and in the tears he shed's when we talk about this. 

So how do we help this sad (depressed?) young person mend his breaking (broken?) spirit? 

Albert Ellis said 'the future of psychology and psychotherapy is in the school system' but 'the future' is yet to arrive it would seem. Educationalists and academics would do well to consider what is happening on its 'own doorstep' here in south Australia. 

Many schools are using Rational Emotive Behaviour Education to help students understand how their thinking, feeling and behaviour are linked. 

Rubbish is what has been discarded because it has no use (not worth anything) and our young student may have decided that he is of no use. Why has he arrived at this conclusion? If this is his reality where might it lead him?

This young person could do with a daily dose of USA teaching (Unconditional Self Acceptance) where he can be left in no doubt that his worth is not tethered to the views of others or how well or badly he may perform at a task. Rational Emotive Behaviour Education is about doing this and there are many schools applying REBT principles in daily practise across all year levels.

Students of all ages can live happier and healthier lives if they understand how as constructivists their habits of believing are connected to how they feel and how they behave. Their lives may depend on it!